Objectives-To determine the prevalence of musculoskeletal complaints of the back, arms or neck, and legs among nurses, and to investigate the relation between these complaints and various work related and personal variables. Methods-A questionnaire survey was carried out in four nursing homes in The Netherlands. Results-The response was 95% and resulted in 846 completed questionnaires. It was found that a large proportion of the subjects regularly had back complaints (36%) but also had arm or neck (30%) and leg complaints (16%). Almost all respondents (89%) considered nursing work as physically strenuous. Most of them complained of working under time pressure (69%/o), increased work pressure (70%), and having no opportunity to take a break from the work (70%). The physical variables which seem to trouble the subjects most were lifting (65%), working in awkward postures (47%/), and stooping (34%).Moreover, 53% of the subjects responded that the ergonomic lay out of the ward was disagreeable. Most of the work related variables under study seemed to be associated with musculoskeletal complaints. For all types of complaints the strongest associations were found with having to lift heavy loads. Apart from physical stress various aspects of work pressure showed strong associations with the occurrence of musculoskeletal complaints. The variables on the ergonomy of the ward showed less clear associations with musculoskeletal complaints than were found for physical stress and work pressure. Conclusions-From these results it may be concluded that future research of health risks of nursing work should have a wider focus than the relation between physical workload and low back pain. (Occup Environ Med 1996;53:636-641) Keywords: musculoskeletal complaints; physical stress; work pressure; nurses As shown in several studies, nursing work seems to be associated with low back pain' 10 with prevalences found between 42% and 62%.3 67 Depending on the type of work performed and the normally considerable workload in nursing, complaints may also be expected in other regions of the body, for instance in the legs or arm and neck region." However, for musculoskeletal problems at other anatomical sites (arms and neck, legs) it is far less easy to find prevalence rates in the scientific literature. In the study of Stubbs et al5 nurses with back pain were asked to indicate the anatomical site more precisely in a pictogram. The upper back and neck was pointed out as the site of the problem by 4%, and the buttocks and legs by 10% of the subjects with back pain. In a study on nurses in which complaints of the cervical back were examined, apart from thoracic and lumbar spine problems, a prevalence rate of 16% was found.'2 In another study among nursing personnel Lagerstrom et al'3 found prevalences of symptoms of the neck 48%, shoulder 53%, hand 22%, and knee 30%. Severe symptoms established on a nine point scale had lower prevalences on all sites, ranging from 18% for the shoulders to 7% for the knees.Because empirical data are spa...

Exposure-response relationships for endotoxin as measured in dust and longitudinal decline in lung function were studied. A cohort of 171 pig farmers was followed over a 3-yr period. Long-term average exposure to dust and endotoxin was determined by personal monitoring in summer and winter, using data on farm characteristics and activities. Mean decline in FEV1 was 73 ml/yr and in FVC 55 ml/ yr. Long-term average exposure to dust was 2.63 mg/m3 (geometric SD [GSD] 1.30), and to endotoxin, 105 ng/m3 (GSD 1.5). Annual decline in FEV1 was significantly associated with endotoxin exposure. An increase in exposure with a factor 2 was associated with an extra decline of FEV1 of 19 ml/yr.

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ABSTRACT:A cas e-referent study of 345 prostate cancer cases and 1,346 referents was carried out in the Netherlands to investigate the relationship between work environment and prostate cancer risk. Cases were selected from the Cancer Registry of the Comprehen sive Cancer Centre IKO. Referents (men diagnosed with benign prostate hyperplasia) were recruited with assistance of the pathology laboratories in the IKO region. Questionnaires were mailed to all subjects to obtain information on their work history and occupational exposure. Moreover, workers in farming (n = 323), and in metal work and maintenance (n = 340), were requested to complete short supplements to the questionnaire inquiring in more detail into specific types of exposure. Significantly elevated risks were found for work in food m anufacturing and for bookkeepers. Significantly elevated odds ratios (OR) were also observed for jobs held between 1960 and 1970 in administration, in storage, or as farm laborer. In addition, a statistically significant excess risk was found for subjects who re ported frequent occupational exposure to cadmium. Cases who worked in farming applied pesticides during significant more days per year than the referents did. A nonsignificantly elevated OR was found for maintenance of tractors and agricultural machinery. Among metal workers, mechanics, and repairmen, nonsignificantly increased ORs were observed with regard to the use of acids, solvents, iron, and steel, and for welding and maintenance of machinery.

BackgroundEmployees with a chronic disease often encounter problems at work because of their chronic disease. The current paper describes the development of a self-management programme based on the Chronic Disease Self-Management programme (CDSMP) of Stanford University to help employees with a chronic somatic disease cope with these problems at work. The objective of this article is to present the systematic development and content of this programme.MethodsThe method of intervention mapping (Bartholomew 2006) was used to tailor the original CDSMP for employees with a chronic somatic disease. This paper describes the process of adjusting the CDSMP for this target group. A needs assessment has been carried out by a literature review and qualitative focus groups with employees with a chronic disease and involved health professionals. On the basis of the needs assessment, the relevant determinants of self-management behaviour at work have been identified for the target population and the objectives of the training have been formulated. Furthermore, techniques have been chosen to influence self-management and the determinants of behaviour and a programme plan has been developed.ResultsThe intervention was designed to address general personal factors such as lifestyle, disease-related factors (for example coping with the disease) and work-related personal factors (such as self-efficacy at work). The course consists of six sessions of each two and a half hour and intents to increase the self management and empowerment of employees with a chronic somatic disease.ConclusionIntervention mapping has been found to be a useful tool for tailoring in a systematic way the original CDSMP for employees with a chronic somatic disease. It might be valuable to use IM for the development or adjusting of interventions in occupational health care.